Public health groups sound warning about preparedness cuts

May 19, 2011 (CIDRAP News) – Two public health advocacy groups this week warned that recent cuts in US preparedness funding could hamstring the nation's response to a health emergency such as a bioterrorism attack, flu pandemic, or natural disaster.

Officials at the National Association of County and City Health Officials (NACCHO) said cuts apply to fiscal year 2011 funding, which was approved in a continuing resolution passed by Congress in April to keep the government running through the end of September. The impact of the cuts is coming to light now, because federal agencies had a May 13 deadline to provide Congress with an operating plan detailing how they would distribute the cuts.

In a press release yesterday, NACCHO said the budget measures cut $107 million in public health preparedness funding for the Centers for Disease Control and Prevention (CDC), which it said erodes the capacity to protect communities. It said that since September 2001 public health departments have used federal preparedness funding to lead and train people in businesses, schools, hospitals, and senior centers to respond to a range of public health threats. It said regular funding is still needed.

Robert M. Pestronk, NACCHO's executive director, said in the statement that the cuts undermine communities and their local health departments. "Without sustained preparedness funding, continued progress is unreliable, and the risk of being caught off guard increases," he said.

Trust for America's Health (TFAH) in a May 16 press release also warned about the impact of the public health and preparedness cuts. Jeff Levi, executive director of TFAH, said in the statement that the CDC faces an 11% cut from fiscal year 2010 levels.

"In one stroke of the pen, the cuts could erase a decade of advances we've made in preventing diseases and preparing for health emergencies," he said. "These cuts are real, and they have real consequences for the health of Americans."

The group applauded the US Department of Health and Human Services (HHS) for keeping prevention funding largely intact.

Laura Hanen, NACCHO's chief of government and public affairs, told CIDRAP News that her group and the Association of State and Territorial Health Officials sent a letter to federal officials when they were working on the budget plans, asking not to cut preparedness. She said the CDC preparedness funding cut represents a 12.7% drop from FY 2010 levels.

Preparedness funding in the CDC budget has been cut every year since FY 2003, Hanen said, and reflects a 29% drop since then Though the cuts raise big concerns at NACCHO, Hanen said the organization knew some cuts were likely and seem to pretty closely match funding levels set out in President Obama's FY 2012 budget.

She said preparedness funding goes to states and four major metropolitan areas, and is then allocated to local health departments. Hanen said it's difficult to generalize the impact that the cuts will have overall, given the differences in jurisdictions. "But some of the smaller local health departments that will be cut to the bone will have a very difficult time," she added.

The cuts will also likely affect academic institutions that have advance practice centers that focus on preparedness tools that have been tried and tested, she said.

In other federal preparedness budget developments, it appears that funding will increase slightly during FY 2011 for the HHS office of the Assistant Secretary for Preparedness and Response (ASPR), established in 2006 to oversee the nation's preparedness activities and to oversee the development of medical countermeasures against public health threats such as pandemic flu and bioterror agents.

Overall, ASPR receives a nearly $22 million increase. The Biodefense Advanced Research and Development Authority (BARDA) portion of the ASPR budget rises from about $305 million in FY 2010 to $415 million in FY 2011. The HHS said the BARDA share of the budget this year includes funding for BioShield management and pandemic influenza management.